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Do hospital characteristics influence Cesarean delivery? Analysis of National Health Insurance claim data

Authors
 Kyu-Tae Han  ;  Seung Ju Kim  ;  Yeong Jun Ju  ;  Jong Won Choi  ;  Eun-Cheol Park 
Citation
 European Journal of Public Health, Vol.27(5) : 801-807, 2017 
Journal Title
 European Journal of Public Health 
ISSN
 1101-1262 
Issue Date
2017
Abstract
Background: The rates of Cesarean delivery in South Korea are high among the Organization for Economic Cooperation and Development countries. We analyzed the relationship between hospital characteristics, in particular hospital volume and market competition and Cesarean delivery. Methods: We used data from National Health Insurance claims (n = 53 591) at 51 hospitals to analyze the relationship between hospital characteristics and Cesarean delivery between 2010 and 2013. We performed logistic regression analysis using generalized estimating equations models that included both inpatient and hospital variables to examine factors associated with Cesarean delivery. Results: Among 53 591 hospitalization cases, 14 425 (26.9%) patients underwent Cesarean delivery. Hospital volumes for deliveries were inversely associated with Cesarean delivery (per increases 100 deliveries = OR 0.896, 95% CI 0.887-0.905). Market competition had inverse relationship with Cesarean delivery (per increase in 10 Hirschmann-Herfindal index points; OR 0.982, 95% CI 0.979-0.985). Conclusions: Our findings suggest that hospital characteristics affect Cesarean delivery. These situations might be caused by maintaining profit with regard to survival or competition, and protecting themselves against unexpected delivery risks. Therefore, based on our findings, health policy makers must make an effort to implement effective strategies for the optimal management of excessive Cesarean rates in South Korea.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/160859
DOI
10.1093/eurpub/ckx061
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실)
Yonsei Authors
박은철(Park, Eun-Cheol)
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Full Text
https://academic.oup.com/eurpub/article/27/5/801/3803433
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